<!DOCTYPE html>
<html lang="en">
<head>
  <meta charset="UTF-8">
  <title>收费</title>
  <!-- Bootstrap -->
  <link href="../static/css/bootstrap.min.css" rel="stylesheet">
  <!-- Font Awesome -->
  <link href="../static/css/font-awesome.min.css" rel="stylesheet">
  <!-- NProgress -->
  <link href="../static/css/nprogress.css" rel="stylesheet">
  <!-- iCheck -->
  <link href="../static/css/green.css" rel="stylesheet">
  <!-- bootstrap-progressbar -->
  <link href="../static/css/bootstrap-progressbar-3.3.4.min.css" rel="stylesheet">
  <!-- JQVMap -->
  <link href="../static/css/jqvmap.min.css" rel="stylesheet" />
  <link href="../static/css/dropzone.min.css" rel="stylesheet">
  <!-- Custom Theme Style -->
  <link href="../static/css/custom.min.css"	rel="stylesheet">

  <!-- add localcss 2016-8-18 -->
  <link href='../static/localcss/appinfoadd.css' rel='stylesheet'>
  <link href='../static/localcss/appinfolist.css' rel='stylesheet'>
</head>
<body class="nav-md footer_fixed">
<div class="container body">
  <div class="main_container">
    <div class="col-md-3 left_col menu_fixed">
      <div class="left_col scroll-view">
        <div class="navbar nav_title" style="border: 0;">
          <a href="#" class="site_title"><i class="fa fa-paw"></i> <span>APP
								BMS</span>
          </a>
        </div>

        <div class="clearfix"></div>

        <!-- menu profile quick info -->
        <div class="profile">
          <div class="profile_pic">
            <img
                    src="../static/images/img.jpg"
                    alt="..." class="img-circle profile_img">
          </div>
          <div class="profile_info">
            <h2><span th:text="${session.user.userName}"></span></h2>
          </div>
        </div>
        <!-- /menu profile quick info -->

        <br />

        <!-- sidebar menu -->
        <div id="sidebar-menu"
             class="main_menu_side hidden-print main_menu">
          <div class="menu_section">
            <h3><span th:text="${session.user.userName}"></span></h3>
            <ul class="nav side-menu">
              <li><a><i class="fa fa-home"></i> 挂号管理 <span
                      class="fa fa-chevron-down"></span>
              </a>
                <ul class="nav child_menu">
                  <li><a href="javascript:;">创建就诊卡</a>
                  </li>
                  <li><a href="javascript:;">门诊挂号</a>
                  </li>
                  <li><a href="javascript:;">挂号信息</a>
                  </li>
<!--
                  <li th:if="${session.user.userType==5}"><a href="/prescription/toDeveloperAppinfomodify">取药</a>
-->
                  </li>
                </ul></li>
            </ul>
          </div>


        </div>
        <!-- /sidebar menu -->

        <!-- /menu footer buttons -->
        <div class="sidebar-footer hidden-small">
          <a data-toggle="tooltip" data-placement="top" title="Settings">
            <span class="glyphicon glyphicon-cog" aria-hidden="true"></span>
          </a> <a data-toggle="tooltip" data-placement="top" title="FullScreen">
          <span class="glyphicon glyphicon-fullscreen" aria-hidden="true"></span>
        </a> <a data-toggle="tooltip" data-placement="top" title="Lock"> <span
                class="glyphicon glyphicon-eye-close" aria-hidden="true"></span>
        </a> <a data-toggle="tooltip" data-placement="top" title="Logout"
                href="${pageContext.request.contextPath }/dev/logout"> <span
                class="glyphicon glyphicon-off" aria-hidden="true"></span> </a>
        </div>
        <!-- /menu footer buttons -->
      </div>
    </div>

    <!-- top navigation -->
    <div class="top_nav">
      <div class="nav_menu">
        <nav>
          <div class="nav toggle">
            <a id="menu_toggle"><i class="fa fa-bars"></i>
            </a>
          </div>

          <ul class="nav navbar-nav navbar-right">
            <li class=""><a href="javascript:;"
                            class="user-profile dropdown-toggle" data-toggle="dropdown"
                            aria-expanded="false"> <img
                    src="../static/images/img.jpg"
                    alt=""><span th:text="${session.user.userName}"></span> <span
                    class=" fa fa-angle-down"></span> </a>
              <ul class="dropdown-menu dropdown-usermenu pull-right">
                <li><a
                        href="/sysUser/exit"><i
                        class="fa fa-sign-out pull-right"></i> Log Out</a>
                </li>
              </ul></li>

            <li role="presentation" class="dropdown">

              <ul id="menu1" class="dropdown-menu list-unstyled msg_list"
                  role="menu">
                <li><a> <span class="image"><img
                        src="../static/images/img.jpg"
                        alt="Profile Image" />
										</span> <span> <span>John Smith</span> <span class="time">3
													mins ago</span> </span> <span class="message"> Film festivals used
												to be do-or-die moments for movie makers. They were where...
										</span> </a></li>
                <li><a> <span class="image"><img
                        src="../static/images/img.jpg"
                        alt="Profile Image" />
										</span> <span> <span>John Smith</span> <span class="time">3
													mins ago</span> </span> <span class="message"> Film festivals used
												to be do-or-die moments for movie makers. They were where...
										</span> </a></li>
                <li><a> <span class="image"><img
                        src="../static/images/img.jpg"
                        alt="Profile Image" />
										</span> <span> <span>John Smith</span> <span class="time">3
													mins ago</span> </span> <span class="message"> Film festivals used
												to be do-or-die moments for movie makers. They were where...
										</span> </a></li>
                <li><a> <span class="image"><img
                        src="../static/images/img.jpg"
                        alt="Profile Image" />
										</span> <span> <span>John Smith</span> <span class="time">3
													mins ago</span> </span> <span class="message"> Film festivals used
												to be do-or-die moments for movie makers. They were where...
										</span> </a></li>
                <li>
                  <div class="text-center">
                    <a> <strong>See All Alerts</strong> <i
                            class="fa fa-angle-right"></i> </a>
                  </div></li>
              </ul></li>
          </ul>
        </nav>
      </div>
    </div>
    <!-- /top navigation -->
    <div class="right_col" role="main">
      <div class="">
        <div class="clearfix"></div>
        <div class="row">
          <div class="col-md-12 col-sm-12 col-xs-12">
            <div class="x_panel">
              <div class="x_title">
                <h2>收银</h2>
                <div class="clearfix"></div>
              </div>
              <div class="x_content">

                <div class="clearfix"></div>
                <form class="form-horizontal form-label-left" action="/prescription/payPrescription" method="post">
                  <input type="hidden" name="id" th:value="${prescription.id}">
                  <div class="item form-group">
                    <label class="control-label col-md-3 col-sm-3 col-xs-12" for="name">病人姓名 <span class="required">*</span>
                    </label>
                    <div class="col-md-6 col-sm-6 col-xs-12">
                      <input id="patientName" class="form-control col-md-7 col-xs-12" th:value="${prescription.patientName}"
                             data-validate-length-range="20" data-validate-words="1" name="patientName"  required="required" readonly type="text">
                    </div>
                  </div>
                  <div class="item form-group">
                    <label class="control-label col-md-3 col-sm-3 col-xs-12" for="name">是否已使用医保 <span class="required">*</span>
                    </label>
                    <div class="col-md-6 col-sm-6 col-xs-12">
                      <input id="medicareFee" class="form-control col-md-7 col-xs-12" th:value="${prescription.medicareFee==0.0?'未使用':'已使用'}"
                             data-validate-length-range="20" data-validate-words="1" name="medicareFee"  required="required" readonly type="text">
                    </div>
                  </div>
                  <div class="item form-group">
                    <label class="control-label col-md-3 col-sm-3 col-xs-12" for="name">需要收取费用 <span class="required">*</span>
                    </label>
                    <div class="col-md-6 col-sm-6 col-xs-12">
                      <input id="payFee" class="form-control col-md-7 col-xs-12" th:value="${prescription.payFee}"
                             data-validate-length-range="20" data-validate-words="1" name="payFee"   required="required" readonly type="text">
                    </div>
                  </div>
                  <div class="item form-group">
                    <label class="control-label col-md-3 col-sm-3 col-xs-12" for="name">支付方式 <span class="required">*</span>
                    </label>
                    <div class="col-md-6 col-sm-6 col-xs-12">
                      <select name="paymentMethod" id="paymentMethod">
                        <option value="1">现金</option>
                        <option value="2">支付宝</option>
                        <option value="3">微信</option>
                      </select>
                    </div>
                  </div>

                  <div class="ln_solid"></div>
                  <div class="form-group">
                    <div class="col-md-6 col-md-offset-3">
                      <button id="send" type="submit" class="btn btn-success">确认缴费</button>
                      <button type="button" class="btn btn-primary" id="back" onclick="history.back()">返回</button>
                      <br/><br/>
                    </div>
                  </div>
                </form>
              </div>
            </div>
          </div>
        </div>

      </div>
    </div>
    <!-- /page content -->
    <!-- footer content -->
    <footer>
      <div class="pull-right">©2016 All Rights Reserved.</div>
      <div class="clearfix"></div>
    </footer>
    <!-- /footer content -->
  </div>
</div>
<!-- jQuery -->
<script src="../static/js/jquery.min.js"></script>
<!-- Bootstrap -->
<script src="../static/js/bootstrap.min.js"></script>
<!-- FastClick -->
<script src="../static/js/fastclick.js"></script>
<!-- NProgress -->
<script src="../static/js/nprogress.js"></script>
<!-- jQuery custom content scroller -->
<script src="../static/js/jquery.mCustomScrollbar.concat.min.js"></script>
<!-- Custom Theme Scripts -->
<script src="../static/js/custom.min.js"></script>
<!-- validator -->
<%--     <script src="../static/js/validator.js"></script> --%>
<!-- dropzone -->
<script src="../static/js/dropzone.js"></script>
<script src="../static/js/jquery-3.6.0.js"></script>
<script>

</script>
</body>
</html>